| NPI | 1518306489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0105X Surgery Surgery of the Hand (Licence: IL 036150334) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34.013284) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101020360) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2024-10-02 |